High Calorie and High Protein Diet to Maintain or Gain Weight Losing weight and muscle mass is a major concern for many people.1 Getting enough protein and calories is essential in order to prevent that from happening. Below are some tips on ways to get more calories and protein into your diet. It is also recommended to exercise to build up that muscle. However, always discuss with your medical team before starting an exercise program. Some helpful ideas to get the most calories and protein in your diet

 Eat small frequent (5-6 meals per day)  liquids between meals, not with, to allow room for nutrient dense  Eat larger portions of fish, poultry, eggs, milk, yogurt, cheese and beans  Prepare canned with milk, not water The amount of extra calories and protein you need will be determined by the dietitian based on your weight and your current needs. Here are some tips to add extra protein:1

Food to Add to your Protein Calories Ways or foods to add it to meals 1 cup chopped or 35g 206 Scrambled eggs, omelets, salads, shredded chicken casseroles. Can be used with most meals 1 cup 1% milkfat cottage 28g 164 Salads, vegetables, pasta, soups, cheese casseroles, tacos, burritos, , fruit salad, smoothies 6 oz Greek yogurt, 17g 140 Fruit salad, smoothies, parfaits. Plain can also be used as substitute for sour cream 1 cup beans (boiled 15g ~225 Salads, stews, soups, pastas black, navy, kidney) ½ cup nonfat dry milk 12g 122 Casseroles, meatloaf, macaroni, meatballs, mashed potatoes, hot cereals Tip: Fortify your milk by adding several tablespoons of dry milk and stirring until dissolved ½ cup tofu (soy) 10g 94 Stir-fry, smoothies, salads, soups 2 tbsp peanut butter or 8g 188 Smoothies, toast, oatmeal, sauces, soy nut butter sandwiches 1 hardboiled egg 6g 78 Tuna, potato salad, cooked seafood, vegetables, salads, , rice, stir-fry 1 oz grated cheese 7g 100 Sauces, soups, omelets, baked (nonfat has higher protein potatoes, salads, sandwiches, content), or cheese steamed vegetables chunks

1 High-Calorie/High-Protein Diet. Lucile Salter Packard Hospital http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/oncology/hchpd.html Created by: Rachel Szalkiewicz, RD

Here are some tips to add extra Calories:

Food to Add to your Calories Protein Ways or foods to add it to meals 2 tbsp peanut butter or 188 8g Smoothies, toast, oatmeal, sauces, soy nut butter sandwiches 1 packet of Carnation® 130 5g Milkshakes, smoothies, Instant Breakfast™ (36g) cereals, pudding 1 tbsp olive oil 119 0g Salads, breads, soups, smoothies, sauces, fish, casseroles, baked goods ¼ cup sour cream 111 1g Add to sauces, potatoes, dips, baked goods, casseroles 1 oz grated cheese 100 7g Sauces, soups, omelets, baked (nonfat has higher protein potatoes, salads, sandwiches, steamed content), or cheese vegetables chunks 1/5 of an avocado 50 0g Smoothies, salads, dips, bread, sandwiches 1 tbsp wheat germ 25 2g Hot cereals, meat dishes, casseroles, creamed soups, smoothies

Oral Supplemental and Products to Consider

Name Calories Protein Enu® 11oz 450 23g Nutrament® 12oz 360 16g Boost Plus® 8oz 360 14g Boost High Protein® 8oz 240 15g Boost Original® 8oz 240 10g Boost Compact® 4oz 240 10g Boost Simply Complete® 8oz 190 10g Ensure Enlive® 8oz 350 20g Ensure Plus® 8oz 350 13g Ensure Compact® 4oz 220 9g Ensure Original® 8oz 220 9g Ensure High Protein® 8oz 160 16g Orgain® Organic Shake 11oz 250 16g Orgain® Organic Vegan 11oz 220 16g Shake Benecalorie® 1.5oz 330 7g Beneprotein® 0.25oz 25 6g Glucerna Advance® * 8oz 200 10g Boost Glucose Control® * 8oz 190 16g Glucerna Shake® * 8oz 190 10g *Made for people have diabetes or high blood sugar

Created by: Rachel Szalkiewicz, RD Recipes for High Protein, High Calorie Smoothies For the following recipes, place all ingredients in a blender (with an optional cup of ice), cover and blend on high speed until mixed well. Store unused drinks in the refrigerator or freezer and take sips or spoonfuls as able throughout the day.

Peanut Butter Banana Smoothie Banana Oat Smoothie 1 medium banana ½ banana 2 Tablespoon peanut butter ½ cup cooked oats 1 cup Greek Yogurt, nonfat, plain 1 cup almond milk, sweetened 1 cup milk (1%) 1 cup soft tofu (~560 calories, 37g protein, 64g carbs) (~425 calories, 18g protein, 33g carbs)

Avocado Mango Smoothie Chai Soymilk Smoothie ½ cup avocado 1 cup chai flavored soymilk 1 cup mango ¼ cup white beans 1 cup milk (1%) (~260 calories, 11g protein, 33g (~320 calories, 12g protein, 44g carbs) carbs)

Apple Peanut Butter Smoothie Pumpkin Spiced Smoothie 2 Tablespoon peanut butter ½ cup pumpkin puree 1 medium apple, cored and sliced 1 cup soft tofu 1 cup Greek Yogurt, nonfat, plain ½ cup vanilla ice cream 1 cup crushed ice ¼ tsp cinnamon (~450 calories, 28g protein, 50g carbs) (~400 calories, 20g protein, 30g carbs)

Sunflower Seed Butter Peach Smoothie Kale Pineapple Smoothie ¼ cup pumpkin seeds 1 cup kale, chopped 1 medium peach 1 cup pineapple 2 Tablespoon sunflower seed butter 1 cup Greek Yogurt, nonfat, plain 1 cup Greek Yogurt, nonfat, plain 1 cup crushed ice 1 cup crushed ice (~360 calories, 24g protein, 37g (~560 calories, 30g protein, 50g carbs) carbs)

Created by: Rachel Szalkiewicz, RD Double Strength Milk Dairy-Free Shake 4 cups of whole milk 8 ounces of unsweetened coconut milk, 10 tablespoons dry skim milk powder oat milk, soy milk, rice milk or almond milk* (1 cup = about 200 calories, 13 grams protein) 2 cups of any flavor of dairy free ice cream (soy or coconut are good options) * Should be used within 48 hours 1 tablespoon of canola or olive oil

1 tablespoon agave syrup (or to taste) Double Strength Skim Milk 1 teaspoon of vanilla extract 4 cups skim milk (About 1280 calories, 14 grams of ¾ cup dry skim milk powder protein** when made with unsweetened (1 cup = about 164 calories, 16 grams coconut milk) protein, 24g sugar) *The calories vary greatly between these types of milk. I recommend coconut milk because it is the highest in Basic Milkshake calories and contains a healthy type of 1 cup of whole milk or ‘double strength fat. If you do not like coconut milk, try milk’ one of the others. 1 cup of ice cream **To increase the protein content of this (About 580 calories and 20g protein shake add a dairy free protein powder when made with ‘double strength milk’) such as pasteurized egg white powder and soy or pea protein powder.

Yogurt Shake ‘Creamsicle’ Shake 7 ounces of plain, Greek yogurt 1 cup sherbet 2 cups of ice cream 1 cup vanilla ice cream 4 ounces of whole milk or ‘double strength milk’ ½ cup whole milk (About 1000 calories, 38 grams of (About 630 calories, 13 grams of protein) protein) This type of shake is also excellent made with different flavors of sorbet and No Added Sugar Shake ice cream. Raspberry sorbet pairs 1 cup of “Double Strength Milk” nicely with vanilla or chocolate ice 14 ounces of plain, Greek yogurt cream depending on flavor preferences. This shake is also easily made ‘dairy 1 frozen banana free’ with substitutions of the milk and 1 cup frozen blueberries ice cream for dairy free versions, and 1 tablespoon of canola or olive oil can have protein increased with protein powders. (see ‘smoothie additives’ ) 1 tablespoon wheat germ

¼ - ½ cup ice

(About 920 calories, 54 grams of protein) Created by: Rachel Szalkiewicz, RD Carnation Instant Breakfast® Shake PB & Banana Smoothie 1 cup of whole milk ¼ cup soft tofu 1 packet of Carnation Instant 1 cup canned coconut milk Breakfast® 1 small banana, frozen 1 cup ice cream 3 tbsp peanut butter (About 660 calories, 20 grams of 1 tbsp honey or agave nectar protein) (About 829 calories, 21 grams of protein) Milky Chocolate Shake 1 cup vanilla ice cream Avocado Shake 1 cup whole milk or ‘double strength 1 cup fortified soy milk milk’ 1 avocado, peeled and seed taken out 1 packet hot chocolate mix 1 cup ice, crushed (About 690 calories, 22 grams of protein when made with double strength milk) 1 tbsp honey or agave nectar (532 calories, 13 grams of protein) Blueberry Power Smoothie ® 2 cups frozen blueberries Boost VHC Shake ® 2 tablespoons ground flax seeds 1 cup Boost VHC ½ cup tofu 4 ounces plain yogurt ½ cup liquid base (milk, juice, etc.) ½ cup ice cream (About 370 calories, 17 grams of protein (673 calories, 29 grams of protein) when made with milk) Low Sugar Boost® VHC Shake Mixed Berry Smoothie 4oz Boost® VHC ½ cup frozen blueberries ½ cup No Sugar Added ice cream ½ cup frozen strawberries 2 tablespoons creamy nut butter ½ cup frozen raspberries 1 packet Beneprotein 2 tablespoons ground flax seeds ½ cup crushed ice 7 ounces Greek plain yogurt (About 585 calories, 27grams of protein, 1 tablespoon honey or to taste 15g sugar) (About 430 calories, 14 grams of protein)

Created by: Rachel Szalkiewicz, RD Non Dairy, MCT oil Shake 8oz coconut milk ½ cup strawberry rice milk ice cream 3 scoops Beneprotein 1 tbsp coconut oil ¼ cup crushed ice (About 442 calories, 18g protein)

Created by: Rachel Szalkiewicz, RD